Minutes of HSE Board Meeting 28 March 2025

Present

Dr Yvonne Traynor (Acting Chairperson), Mr Brendan Whelan, Mr Aogán Ó Fearghail, Mr Tim Hynes, Ms Anne Carrigy, Mr Matt Walsh, Mr Michael Cawley and Mr Kenneth Mealy

Apologies

Mr Ciarán Devane (Chairperson) and Ms Lily Collison

In Attendance for Board Meeting

Mr Bernard Gloster (CEO), Mr Damien McCallion (CTTO), Mr Stephen Mulvany (CFO), Mr Pat Healy (ND Services & Schemes), Mr David Walsh (ND Access & Integration), Mr Tony Canavan (REO West & North West), Ms Sandra Broderick (REO Mid West), Ms Kate Killen White (REO Dublin & Midlands), Ms Martina Queally (REO Dublin & South East), Dr Andy Phillips (REO South East), Mr Joseph Duggan (Chief Internal Auditor); Mr Brian O’Connell (ND Strategic Health Infrastructure and Capital Delivery); Mr Patrick Lynch (ND Planning & Performance); Mr Joe Ryan (ND Public Involvement, Culture and Risk Management), Mr Mark Brennock (ND Communications), Dr Siobhán Ni Bhrian, HSE National Clinical Director Integrated Care, Mr Patrick Clerkin (Louth and Meath IHA), Niamh Doody (CEO Office), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Patricia Perry (Office of the Board).

Joined the meeting

Jean Neary, Christopher Schultz (Item 4.3), Neal Mullen (CISO) (Item 6.1)

Minutes reflect the order in which items were considered and are numbered in accordance with the original agenda. All performance/activity data used in this document refers to the latest information available at the time.

The Acting Chairperson welcomed members to the meeting and provided an update to the Board during their private session.

2.1 Declarations of Interest

No other conflicts of interest were declared.

2.2 Chairperson’s Remarks

The Acting Chairperson provided an update to the Board on a number of matters that would be discussed during the meeting.

2.3 Ministerial Correspondence

The Board noted the following correspondence.

· Letter from Minister for Children, Disability & Equality re approval of Capital Plan dates 03 March 2025

2.3 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 28 February 2025.

3.1 Audit and Risk Committee

The minutes of the Committee meeting of 14 February 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 07 March 2025.

The Board held a discussion on the following areas:

• initiatives and timelines being considered relating to Non-pay savings,
• update by the National Productivity Unit with regard to the Review of the Office of Legal Services
• Internal Audit overdue recommendations and it was agreed that a REO would attend the next Committee meeting.

3.2 Performance Committee

The minutes of the Committee meetings of 20 February 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 20 March 2025.

The Board held a discussion on the following areas:

• update on Residential and Respite Services, and Section 39 Pay related funding increase
• implementation of recommendations by the service provider and potential learnings in the ‘Holly’ Report

3.3 Strategy and Reform Committee

The minutes of the Committee meetings of 19 February 2025 were noted. The Committee Chairperson provided an overview to the matters considered at the Committee meeting that took place on 12 March 2025.

The Board held a discussion on the following areas:

• Implementation of the Organisation Culture Programme
• Support for the Climate Action and Sustainability Programme incl. HSE Climate Action Strategy 2023-2050 and HSE Capital and Estates Infrastructure Decarbonisation Roadmap
• PwC NIST Cyber Security Framework (CSF) and the importance of Board and Committee assurance concerning audit findings.

4.1 CEO briefing to Board

The Board and CEO held a discussion in relation to items raised in the CEO report.

4.2 CEO briefing with REOs – Review of YTD

REOs joined the meeting

The Acting Chairperson welcomed the Regional Executive Officers (REOs) to the meeting. Each REO provided the Board with an oversight of developments, achievements and challenges in each Region over the last 12 months. The Board acknowledged the work to date of each of the REO’s and discussed various issues that arose.

4.3 CEO Monthly Report

Members of the Senior Leadership Team joined the meeting

The Board noted and discussed Our Lady’s Hospital Navan Position Paper and draft Implementation Plan, previously circulated and agreed to endorse the primary decision of the Department of Health and the HSE regarding Navan Hospital under the Small Hospital Framework, and the decision on the condition that the Implementation Plan is achieved prior to transitioning Navan to a Model 2 Hospital. It was agreed that the Executive would seek a review from the Department of Health and provide approval for the Implementation Plan to allow the HSE to construct a reasonable timeline for completion.

The CEO advised the Board that he attended a Cabinet Committee on Disabilities on 24 March 2025 and had extensive engagement with the Department of Children, Disability and Equality, and the Department of the Taoiseach. The Board noted engagements scheduled with staff of CDNT and related services in early April, which will be followed by a session with family members, and welcomed that through these engagements, the shared experience in delivering and planning Children’s Disability Services can be explored and collectively improved. A further update on disabilities will be brought back to the Board at the April meeting.

It was noted that the Quarterly meeting between the Chair and the Minister for Children, Equality and Disabilities scheduled for 27 March is being rescheduled.

The CEO provided an update to the Board in relation to notification issued by unions of the intention to initiate industrial action at the end of March in the form of work to rule, and his intention to deescalate the action. The Board noted that the CEO has referred matters to the Workplace Relations Commission with invitations to unions issued.

In relation to the ongoing discussions and refinements aimed at improving financial governance and controls across the HSE, the CEO reported to the Board that while spending limits continued to be relied on, pay control has been established and non-pay savings measures mandated.

The CEO reported that after consideration and ensuring that a balance between good governance and controls which include both efficacy in the running of the organisation and reduce exposure to risk, he outlined recommendations to the Board for adoption in relation to Property, Vacant Property, Spend Approval Limits, Duplicate Payment Risk and P2P Processes and a company providing sensors and associated product to the HSE. The Board agreed that papers would be brought before the Audit and Risk Committee relating to the first four recommendations and noted the CEO’s recommendation to the latter.

In relation to workforce deployment, the CEO reported to the Board on the recent focus regarding the deployment of senior decisions makers, in particular Consultants, over the 6 days allowed by the Public Only Consultant Contract. A comprehensive review of the workplans of the consultant workforce was initiated in March, with an analysis of 4,563.5 (98.7%) WTE consultants, and the data was presented to the Board.

The CEO reported to the Board that the existing clinical and operational model for HSE Laboratory Services is not meeting current needs. An extensive engagement and consultation process, led by Prof. Martin Cormican, has resulted in the draft Strategic Plan for Laboratory Service Reform 2026 - 2035, which has been supported by the Department of Health, previously circulated to the Board.

The Board noted that significant investment is required to achieve its ambitions, however ultimately it is anticipated to deliver better value for money and improved services for patients over the lifetime of the plan. It will now go through a further process and can only be decided on finally by the Department of Health and DPER.

The CEO provided an update in relation to the National Electronic Health Record (EHR) Preliminary Business Case and the National Shared Care Record, and will be brought back to the Board for approval, subject to Committee review. The Board noted that further analysis of the data is continuing and an initial view has been shared with the Minister for Health.

The CEO advised the Board of the planned retirement of Mr David Walsh, ND Access & Integration in April 2025.

The CEO advised that the Deputy CEO would take the remainder of the meeting, and the CEO and REOs left the meeting.

National Performance Report

The new monthly National Performance Report (NPR) January 2025 data was presented to the Board, which replaces the Board Strategic Scorecard. The National Director Planning & Performance discussed the NPR with the Board and particular items were highlighted for noting.

It was noted that the Performance Committee considered the NPR at its meeting of 20 March 2025 and had provided feedback, which will be reflected in the ongoing development of the NPR.

The Board considered and approved the January 2025 NPR for submission to the Minister for Health, and Department of Children, Disability and Equality, and noted that once submitted, the NPR will be published on hse.ie.

5.1 Adoption of Draft AFS 2024 in line with Health Act 2004

The Deputy CEO recommended the draft Annual Financial Statements (AFS) 2024 to the Board for adoption. The documents presented were the:

• draft Financial Statements 2024 and notes to the Accounts including draft accounting

policies (AFS);

• draft Statement on Internal Control (SIC)

The ARC Chair advised the Board that the ARC had reviewed the draft AFS 2024 at its meeting on 07 March 2025 and on behalf of the ARC recommended the draft AFS to the Board for adoption.

In accordance with the requirements of Section 36 of the Health Act 2004, the Board adopted the draft AFS and draft Statement of Internal Controls for submission to the Minister for Health and Minister for Children, Disability and Equality and the C&AG for audit and the Chairperson and CEO were nominated to sign the accounts. Decision No.: 280325/04

The Board noted that the audit is on-going and the accounts will not be considered final until the audit has concluded and any material changes that may arise have been considered and actioned. It is expected subject to the progression of the C&AG audit that the final draft will be brought to the Board in May and any material changes to the AFS and disclosures will be explained.

5.2 Contracts & Properties

As recommended by the Audit & Risk Committee for approval, the Board considered and approved the following proposed contracts and properties:

1. 1. 1. Contract Award for new 42 Bed Medical Block at Sligo University Hospital Decision No.: 280325/05

6.1 HSE National Cybersecurity Plan

The Deputy CEO / CTTO introduced Mr Neal Mullen, Chief Information Security Officer (CISO) to the meeting. Documentation was circulated in advance of the meeting which outlined the HSE National Cybersecurity Plan (the Plan), which sets out a robust and comprehensive strategy to protect Ireland's health service infrastructure from the growing landscape of cyber threats. The Board noted that Plan focuses on fortifying critical systems, ensuring the resilience of essential healthcare services, and safeguarding the sensitive data that underpins public health and safety, and welcomed that through its implementation, the HSE aims to strengthen its preparedness and response measures, aligning with best practices in cybersecurity and regulatory requirements.

The Board noted that the Plan is overseen and tracked using the NIST Cybersecurity Framework (CSF), a highly adaptable tool central to the Plan's execution. The NIST CSF is instrumental in improving operational efficiencies and achieving compliance. It also serves as the core framework utilised by the National Cyber Security Centre (NCSC) and PwC to assess progress and overall cybersecurity maturity.

The CISO advised that all audit findings, recommendations and actions from the PwC Post-Incident Review (PIR) Report 2021; the NCSC Compliance Report 2022; the PwC - NIST Maturity Reassessment 2024 Report; and the NCSC NIS 2024 Audit are called out in the Plan and are aligned to the NIST CSF, making the plan easily Auditable; Compliant; Standardised; Measurable and Future-proofed.

The Board discussed the importance of the enablement of the Health Regions and Section 38 and 39 agencies and were advised that the CISO will support them on uplifting their cyber security posture through the PEPA model; technology & transformation policy standards, and with Business Information Security Officers for each region who will report to the Regional Director Technology & Transformation but will also have a clear reporting line back to the CISO office to ensure a nationally driven consistent approach to security.

The CISO reported to the Board that the Plan has been formally adopted by the Cyber Security Steering Group, established by the CEO and chaired by the Deputy CEO / CTTO, and oversees the full implementation of the cybersecurity programme and is subjected to rigorous review by multiple bodies, including the NCSC, Gartner, and internal stakeholders including the Strategy & Reform Committee. PwC, as the Board-appointed auditors have examined the Plan, its approach, and expected outcomes, providing independent assurance that the Plan, if implemented as outlined, will achieve its cybersecurity goals and objectives.

The Board asked that a discussion with regard to the NCH take place at the April 2025 meeting.

There was no further business. The meeting concluded at 2.15pm.